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A computerized social cognitive intervention for nutrition behavior: Direct and mediated effects on fat, fiber, fruits, and vegetables, self-efficacy, and outcome expectations among food shoppers

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Annals of Behavioral Medicine

Abstract

This study examined the direct and mediated impact of a self-administered, computer-based intervention on nutrition behavior, self-efficacy, and outcome expectations among supermarket food shoppers. The intervention, housed in kiosks in supermarkets and based on social cognitive theory, used tailored information and self-regulation strategies delivered in 15 brief weekly segments. The study sample (N = 277), stratified and randomly assigned to treatment or control, was 96% female, was 92% White, had a median annual income of about $35,000, and had a mean education of 14.78 ±2.11 years. About 12% of the sample reported incomes of $20,000 or less, and about 20% reported 12 years or fewer of education. Analysis of covariance immediately after intervention and at a 4- to 6-month follow-up found that treatment led to improved levels of fat, fiber, and fruits and vegetables. Treatment also led to higher levels of nutrition-related self-efficacy, physical outcome expectations, and social outcome expectations. Logistic regression analysis determined that the treatment group was more likely than the control group to attain goals for fat, fiber, and fruits and vegetables at posttest and to attain goals for fat at follow-up. Latent variable structural equation analysis revealed self-efficacy and physical outcome expectations mediated treatment effects on nutrition. In addition, physical outcome expectations mediated the effect of self-efficacy on nutrition outcomes. Implications for future computer-based health promotion interventions are discussed.

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References

  1. Willet WC, Trichopoulos D: Nutrition and cancer: A summary of evidence.Cancer Causes and Control. 1996,7:178–180.

    Article  Google Scholar 

  2. U.S. Department of Health and Human Services:Healthy People 2000: National Health Promotion and Disease Prevention Objectives, DHHS Publication No. (PHS) 91-50212. Washington, DC: U.S. Government Printing Office, 1990.

    Google Scholar 

  3. U.S. Department of Health and Human Services:Healthy People 2010, Conference Edition, Volumes I and II. Washington, DC: U.S. Department of Health and Human Services, 2000. Retrieved July 24, 2000 from the World Wide Web: http://web.health.gov/healthypeople/

    Google Scholar 

  4. Hill JO, Peters JC: Environmental contributions to the obesity epidemic.Science. 1998,280:1371–1374.

    Article  PubMed  CAS  Google Scholar 

  5. Must A, Spandano J, Coakley EH, et al.: The disease burden associated with overweight and obesity.Journal of the American Medical Association. 1999,282:1523–1529.

    Article  PubMed  CAS  Google Scholar 

  6. Serdula MK, Mokdad AH, Williamson DF, et al.: Prevalence of attempting weight loss and strategies for controlling weight.Journal of the American Medical Association. 1999,282:1353–1358.

    Article  PubMed  CAS  Google Scholar 

  7. Jones DA, Ainsworth BE, Croft JB, et al.: Moderate leisure-time activity: Who is meeting the public health recommendations?Archives of Family Medicine. 1998,7:285–289.

    Article  PubMed  CAS  Google Scholar 

  8. Koplan JP, Dietz WH: Caloric imbalance and public health policy.Journal of the American Medical Association. 1999,282:1579–1581.

    Article  PubMed  CAS  Google Scholar 

  9. Brug J, Glanz K, Van Assema P, Kok G, Van Breuklen GJP: The impact of computer-tailored feedback and iterative feedback on fat, fruit and vegetable intake.Health Education and Behavior. 1998,25:517–531.

    Article  PubMed  CAS  Google Scholar 

  10. Campbell MK, DeVillis BM, Strecher VJ, et al.: Improving dietary behavior: The effectiveness of tailored messages in primary care settings.American Journal of Public Health. 1994,84: 783–787.

    PubMed  CAS  Google Scholar 

  11. Clark NM, Ghandour G, Houston Miller N, et al.: Development and evaluation of a computer-based system for dietary management of hyperlipidemia.Journal of the American Dietetic Association. 1997,97:146–150

    Article  PubMed  CAS  Google Scholar 

  12. Glasgow RE, LaChange PA, Toobert DJ, et al.: Long term effect and costs of brief behavioral dietary intervention for patients with diabetes delivered from the medical office.Patient Education and Counseling. 1997,32:175–184.

    Article  PubMed  CAS  Google Scholar 

  13. Lowensteyn I, Joseph L, Levinton C, et al.: Can computerized risk profiles help patients improve their coronary risk? The results of the Coronary Health Assessment Study (CHAS).Preventive Medicine. 1998,27:730–737.

    Article  PubMed  CAS  Google Scholar 

  14. Marcus BH, Bock BC, Pinto BM, et al.: Efficacy of an individualized, motivationally-tailored physical activity intervention.Annals of Behavioral Medicine. 1998,20:174–180.

    PubMed  CAS  Google Scholar 

  15. Skinner CS, Siegfried JC, Kegler MC: The potential of computers in patient education.Patient Education and Counseling. 1993,22:27–34.

    Article  PubMed  CAS  Google Scholar 

  16. Thomas R, Cahill J, Santilli L: Using an interactive computer game to increase skill and self-efficacy regarding safer sex negotiation: Field test results.Health Education and Behavior. 1997,24:71–86.

    Article  PubMed  CAS  Google Scholar 

  17. Winzelberg AJ: The analysis of electronic support group for individuals with eating disorders.Computers in Human Behavior. 1997,13:393–407.

    Article  Google Scholar 

  18. Annesi {GNJJ}: Effects of computer feedback on adherence to exercise.Perceptual and Motor Skills. 1998,87:723–730.

    PubMed  CAS  Google Scholar 

  19. Winett RA, Roodman AA, Winett SG, et al.: The effect of the Eat4Life Internet-based health behavior program on high school girls’ nutrition and exercise practices.Journal of Gender, Culture, and Health. 1999,4:239–254.

    Article  Google Scholar 

  20. Robinson TN: Community health behavior change through computer network health promotion: Preliminary findings from Stanford Health-Net.Computer Methods and Programs in Biomedicine. 1989,30:137–144.

    Article  PubMed  CAS  Google Scholar 

  21. Winett RA, Anderson ES, Bickley PG, et al.: Nutrition for a Lifetime System: A multimedia system for altering supermarket shoppers’ purchases to meet nutritional guidelines.Computers in Human Behavior. 1997,13:371–382.

    Article  Google Scholar 

  22. Winett RA, Moore JF, Wagner JA, et al.: Altering shoppers’ supermarket purchases to meet nutrition guidelines: Interactive information systems.Journal of Applied Behavior Analysis. 1991,24:95–105.

    Article  PubMed  CAS  Google Scholar 

  23. Robinson TN, Patrick K, Eng TR, Gustafson D: An evidence-based approach to interactive health communication. A challenge to medicine in the information age.The Journal of the American Medical Association. 1998,280:1264–1269.

    Article  CAS  Google Scholar 

  24. Bandura A:Self Efficacy: The Exercise of Control. New York: Freeman, 1997.

    Google Scholar 

  25. Anderson ES, Winett RA, Bickley PG, et al.: The effects of a multimedia system in supermarkets to alter shoppers’ food purchases: Nutritional outcomes and caveats.Journal of Health Psychology. 1997,2:221–232.

    Article  Google Scholar 

  26. U.S. Department of Health and Human Services:Consensus Workshop on Dietary Assessment: Nutrition Monitoring and Tracking the Year 2000 Objectives. Hyattesville, MD: DHHS, Public Health Service, Centers for Disease Control and Prevention, National Centers for Health Statistics, 1994.

    Google Scholar 

  27. Kristal AR, Beresford AA, Lazovich DA: Assessing change in the diet-intervention research.American Journal of Clinical Nutrition. 1994,59(Suppl.):185S-189S.

    PubMed  CAS  Google Scholar 

  28. Newell SA, Girgis A, Sanson-Fisher RW, Savolainen NJ: The accuracy of self-reported health behaviors and risk factors related to cancer and cardiovascular disease in the general population: A critical review.American Journal of Preventive Medicine. 1999,17:211–229.

    Article  PubMed  CAS  Google Scholar 

  29. Walberg-Rankin J, Winett RA, Anderson ES, et al.: Food purchase patterns at the grocery store and their relationship to family characteristics.Journal of Nutrition Education. 1998,30:81–88.

    Article  Google Scholar 

  30. Anderson ES, Winett RA, Wojcik JR: Social cognitive determinants of nutrition behavior: An exploratory analysis using SEM.Health Psychology. 2000,19:479–486.

    Article  PubMed  CAS  Google Scholar 

  31. Block Dietary Data Systems:Block 95 Food Frequency Questionnaire. Berkley, CA: Block Dietary Data Systems, 1995.

    Google Scholar 

  32. Pedhazur EJ, Schmelkin LP:Measurement, Design, and Analysis: An Integrated Approach. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1991.

    Google Scholar 

  33. Reiss AJ:Occupations and social status / Albert J. Reiss, Jr., with Otis Dudley Duncan, Paul K. Hatt, Cecil C. North. New York: Free Press of Glencoe, 1961.

    Google Scholar 

  34. Byron RM, Kenny DA: The moderator mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology. 1986,51:1173–1182.

    Article  Google Scholar 

  35. SPSS, Inc.: SPSS (Version 10.0) [Computer software]. Chicago: SPSS, Inc., 1999.

    Google Scholar 

  36. Jöreskog KG, Sörbom D: LISREL (Version 8.30) [Computer software]. Chicago: Scientific Software International, Inc., 1999.

    Google Scholar 

  37. Schumacker RE, Lomax RG:A Beginner’s Guide to Structural Equation Modeling. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 1996.

    Google Scholar 

  38. Campbell MK, Denmark-Wahnefried W, Symons M, et al.: Fruit and vegetable consumption and prevention of cancer: The Black churches unified for better health project.American Journal of Public Health. 1999,89:1390–1396.

    PubMed  CAS  Google Scholar 

  39. Resnick B, Palmer MH, Jenkins JS, Spellbring AM: Path analysis of efficacy expectations and exercise behaviour in older adults.Journal of Advanced Nursing. 2000,31:1309–1315.

    Article  PubMed  CAS  Google Scholar 

  40. Clark DO, Nothwehr F: Exercise self-efficacy and its correlates among socioeconomically disadvantaged older adults.Health Education and Behavior. 1999,26:533–546.

    Google Scholar 

  41. Hayes LM, Clark DO: Correlates of physical activity in a sample of older adults with type 2 diabetes.Diabetes Care. 1999,22:706–712.

    Article  Google Scholar 

  42. Sorenson M: Maintenance of exercise behavior for individuals at risk for cardiovascular disease.Perceptual and Motor Skills. 1997,85:867–880.

    Google Scholar 

  43. Pavone RM, Burnett KF, LaPerriere A, Perna FM: Social cognitive and physical health determinants of exercise adherence for HIV-1 seropositive, early symptomatic men and women.International Journal of Behavioral Medicine. 1999,5:245–258.

    Article  Google Scholar 

  44. Kuppens R, Eriksen MP, Adriaanse HP, et al.: Determinants of fat and fiber consumption in American rural energy workers.Preventive Medicine. 1996,25:212–217.

    Article  PubMed  CAS  Google Scholar 

  45. Resnicow K, Davis-Hearn M, Smith M, et al.: Social-cognitive predictors of fruit and vegetable intake in children.Health Psychology. 1997,16:272–276.

    Article  PubMed  CAS  Google Scholar 

  46. Sieving R, Resnick MD, Bearinger L, et al.: Cognitive and behavioral predictors of sexually transmitted disease risk behavior among sexually active adolescents.Archives of Pediatric Adolescent Medicine. 1997,15:243–251.

    Google Scholar 

  47. Thompson NJ, Potter JS, Sanderson CA, Maibach EW: The relationship of sexual abuse and HIV risk behaviors among heterosexual adult female STD patients.Child Abuse and Neglect. 1997,21:149–156.

    Article  PubMed  CAS  Google Scholar 

  48. Domel SB, Baranowski T, Davis HC, et al.: A measure of stages of change in fruits and vegetable consumption among fourth-and fifth-grade school children: Reliability and validity.Journal of American College of Nutrition. 1996,15:56–64.

    CAS  Google Scholar 

  49. Clark DO, Patrick DL, Grembowski D, Durham ML: Socioeconomic status and exercise self-efficacy in late life.Journal of Behavioral Medicine. 1995,1 8:355–376.

    Article  Google Scholar 

  50. Dijkstra A, DeVries H, Roijackers J: Computerized tailored feedback to change cognitive determinants of smoking: A Dutch field experiment.Health Education Research. 1998,13:197–206.

    Article  PubMed  CAS  Google Scholar 

  51. Wojcik JR, Winett RA, Harris BE: Computer and Internet access in two rural majority churches and one small-city African-American church in Southwest Virginia. Society of Behavioral Medicine Annual Meeting. Nashville, TN: 2000.

  52. Winett RA, Anderson ES, Whiteley JA, et al.: Church-based health behavior programs: Using social cognitive theory to formulate interventions for at-risk populations.Applied and Preventive Psychology. 1999,8:141–157.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. CRHB (0274), Department of Psychology, Virginia Tech, 24061, Blacksburg, VA

    Eileen S. Anderson Ed.D., Richard A. Winett Ph.D. & Janet R. Wojcik Ph.D.

  2. PC Resources, Inc., Blacksburg, Virginia

    Sheila G. Winett M.S. & Todd Bowden B.S.

Authors
  1. Eileen S. Anderson Ed.D.
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  2. Richard A. Winett Ph.D.
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  3. Janet R. Wojcik Ph.D.
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  4. Sheila G. Winett M.S.
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  5. Todd Bowden B.S.
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Corresponding author

Correspondence to Eileen S. Anderson Ed.D..

Additional information

This study was funded by The National Cancer Institute Grant 2RO1CA45926-06A1. The Institutional Review Board of the Virginia Polytechnic Institute and State University approved the study. An earlier version of this article was presented at the 2000 Annual Conference of the Society of Behavioral Medicine, April 5-8, 2000.

We acknowledge the contributions of Janet Walberg-Rankin, Ph.D., in developing NLS content and measurement strategies; Patricia G. Bickley, Ph.D., in developing NLS content and procedures; Jessica Whitely for background research; and Archie Fralin from the Kroger Co., Inc. in assisting the conduct of the project in five stores.We also acknowledge the work of Jennifer Fretz, Jessica Psujek, Felicity Mitton, Brad Harris, and David Wang in database management. These staff members, as well as Susan Allaie, Ann Jones, Oliver Chen, Anup Sharma, Ruby Cockran, Kristi Graves, and Rosell Jeffries, were essential to participant recruitment, data entry, and related tasks. We are also grateful to the store managers and personnel of Kroger supermarkets for their help and support.

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Anderson, E.S., Winett, R.A., Wojcik, J.R. et al. A computerized social cognitive intervention for nutrition behavior: Direct and mediated effects on fat, fiber, fruits, and vegetables, self-efficacy, and outcome expectations among food shoppers. ann. behav. med. 23, 88–100 (2001). https://doi.org/10.1207/S15324796ABM2302_3

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